TITLE:
The Use of Positron Emission Tomography in the Diagnosis of Prosthetic Arteriovenous Hemodialysis Graft Infection: A Case Study
AUTHORS:
Bertrand Saint-Lebes, Celine Dubuis, Sebastien Deglise, François Saucy, Jean-Marc Corpataux
KEYWORDS:
Hemodialysis Access; Graft Infection; PET-CT
JOURNAL NAME:
Surgical Science,
Vol.5 No.2,
February
18,
2014
ABSTRACT:
Patients on chronic
hemodialysis (HD) required
efficient arterio-venous access. Different
types of vascular access
are commonly used, such as
native arteriovenous (AV) fistula, prosthetic AV graft, central venous
catheter, or temporary and tunnelled cuffed catheters. Vascular access—related
morbidity remains the major issue for patients requiring long-term therapy. Vascular access infection constitutes the most
challenging and life-threatening complication of vascular access and causes
significant morbidity, loss of
access and mortality. Vascular access infection is defined as local signs at
the vascular access site or a positive blood culture with no know source other
than the vascular access. The critical issue in the management of AV graft
infection is the need to
remove the infection and to maintain HD access with reduced morbidity. The
diagnosis of infected AV graft is not always easy, especially with low-grade
infection or atypical presentation. Fluorodeoxyglucose positron emission
tomography (FDG-PET) is an imaging method that uses a radioactively labelled
tracer (18 fluorodeoxy glucose) which is taken up by tissue with high metabolic
activity, such as neoplastic and inflammatory lesions. FDG-PET has been
proposed to visualise localisation of infection in patients with suspected
prosthetic graft infection. We report a case of methicilin resistant
staphylococcus aureus (MRSA) hemodialysis access infection without local
inflammatory signs diagnosed on the PET-CT.